Evaluation of upper extremity performance in women with and without breast cancer-related lymphedema.

BACKGROUND: Breast cancer-related lymphedema may negatively affect upper extremity function; however, objective evidence regarding task-oriented upper extremity performance and hand reaction time in this population remains limited. PURPOSE: To compare upper extremity performance and hand reaction time in women with and without breast cancer-related lymphedema after breast cancer treatment. STUDY DESIGN: Cross-sectional study. METHODS: Fifty women after breast cancer treatment were included: 25 with breast cancer-related lymphedema and 25 without lymphedema. Limb volume was calculated using the frustum formula from circumferential measurements taken at 5-cm intervals. Upper extremity performance was assessed using the Timed Functional Arm and Shoulder Test (TFAST), and hand reaction time was assessed using the Nelson Hand Reaction Test (NHRT). RESULTS: Age, body mass index (BMI), pain intensity, and time since surgery were comparable between groups. Affected-side arm volume was higher in the breast cancer-related lymphedema group than in the non-lymphedema group (2095.5 ± 425.7 cm³ vs 1695.9 ± 365.5 cm³; mean difference: 399.6 cm³; p < 0.001). TFAST scores were lower in women with breast cancer-related lymphedema on the affected/dominant side (median: 41 vs 53; r = 0.69; p < 0.001) and on the unaffected/non-dominant side (median: 39 vs 57; r = 0.67; p < 0.001). NHRT reaction time in the affected hand was longer in the breast cancer-related lymphedema group (median: 0.259 seconds vs 0.234 seconds; r = 0.66; p < 0.001). Limb volume was negatively correlated with affected-side TFAST scores in women with breast cancer-related lymphedema (r = -0.58, p = 0.002), but not with NHRT scores (r = 0.15, p = 0.227). CONCLUSIONS: Breast cancer-related lymphedema is associated with clinically meaningful impairments in task-oriented upper extremity performance and longer affected-hand reaction time. Performance-based assessment may help identify functional impairments associated with breast cancer-related lymphedema and guide individualized hand and upper extremity rehabilitation for women after breast cancer treatment.